Neoadjuvant chemotherapy followed by surgery (NCS) has not been fully evaluated clinically. Currently, the main regimen of neoadjuvant chemotherapy (NAC) used in NCS includes cisplatin. The antitumor effects of NAC reduce lymph node metastasis and the tumor diameter in patients prior to surgery, and this can reduce the number of high risk patients who require postoperative radiation therapy. Many randomized controlled trials (RCTs) have examined the long-term prognosis of NCS compared to primary surgery, but the utility of NCS remains uncertain. The advent of concurrent chemoradiotherapy (CCRT) has markedly improved the outcome of radiotherapy (RT), and CCRT is now used as a standard method in many cases of advanced bulky cervical cancer. NCS gives a better treatment outcome than radiation therapy alone, but it is important to verify that NCS gives a similar or better outcome compared to CCRT.

Key Clinical MessagePeritoneal pregnancy may cause severe abdominal bleeding without genital bleeding as early as the fifth week of gestation. Awareness that pregnancy can exist in unusual locations is imperative.

Angiosarcoma is a rare malignant tumor with an aggressive clinical course and a poor prognosis. Intraperitoneal angiosarcoma, especially originating from the omentum, is extremely rare. We report a case of radiation-induced angiosarcoma of the omentum that arose in a 38-year-old female seven years after concurrent chemoradiotherapy for cervical cancer. The primary tumor was unknown until diagnostic laparoscopy revealed an unresectable omental mass. Pathological examination revealed high-grade malignant cells positive for endothelial markers. Although the small number of cases limits the consensus on optimal therapy for advanced angiosarcoma, the patient was managed successfully by taxane-based chemotherapy, leading to complete response and consequent complete cytoreductive surgery. Our report is the fifth case of radiation-induced angiosarcoma of the omentum, and all have developed after treatment for gynecologic cancer. Although very rare, this complication should be considered after radiation therapy in cancer treatment, particularly given the increasing importance of this therapy.

Because of later marriage and postponement of childbearing, the number of fibroid cases being treated via uterine preservation procedures is increasing. Although the available choices for uterine preservation are increasing (i.e., gonadotropin releasing hormone analogs, uterine artery embolization, and focused ultrasound ablation), a myomectomy is the only well-established procedure for preservation of fertility. In order to decrease blood loss and ensure safety during a myomectomy, the most important element is prompt suturing of the myometrium. However, when we perform a laparoscopic myomectomy, several restrictions make suturing difficult (i.e., needle direction, suturing speed, and visibility